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Changes to notification process for newly credentialed practitioners

March 31, 2016

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Providers who are interested in participating with Independence must complete and submit a credentialing application; however, submission of the credentialing application and required supporting documentation does not guarantee inclusion in Independence's provider networks.

Historically, once an application was approved, the provider would receive two forms of notification: one letter to confirm approval and another letter to inform of his or her billing provider ID number. Going forward, in an effort to streamline this process, each newly credentialed provider will receive only one letter of notification once his or her application is approved.

Keep in mind that, although the credentialing status is approved, new providers are not immediately set up in the claims processing system. Therefore, we encourage newly approved providers to wait at least 20 business days from the date your credentialing is approved before submitting claims for payment. Claims received prior to proper provider set-up may result in inaccurate payment or rejections. In addition, you will not be provided an individual provider number for claims submission as you have in the past. As previously notified, please continue using a valid National Provider Identifier (NPI) when submitting claims for Independence members. This NPI requirement applies to all claim submissions.

Note: This information does not apply to providers contracted with Magellan Healthcare, Inc., an independent company.

Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most Independence Blue Cross members.

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